Provider Demographics
NPI:1063573038
Name:SERLIN, SVETLANA (DO)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:SERLIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3040 W SALT CREEK LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1069
Mailing Address - Country:US
Mailing Address - Phone:847-385-7323
Mailing Address - Fax:847-483-7043
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:DOCTORS BLDG ONE, SUITE 415
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60194-1019
Practice Address - Country:US
Practice Address - Phone:847-490-4222
Practice Address - Fax:847-490-4225
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-106120208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I10665Medicare UPIN